Clinically Silent Cerebral Ischemic Events After Cardiac Surgery: Their Incidence, Regional Vascular Occurrence, and Procedural Dependence

2006 ◽  
Vol 81 (6) ◽  
pp. 2160-2166 ◽  
Author(s):  
Thomas F. Floyd ◽  
Pallav N. Shah ◽  
Catherine C. Price ◽  
Francis Harris ◽  
Sarah J. Ratcliffe ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cerebral Ischemic ◽  
Ischemic Events

Further Evidence Relating Mitral-Valve Prolapse to Cerebral Ischemic Events

1980 ◽  
Vol 302 (3) ◽  
pp. 139-144 ◽  
Author(s):  
Henry J. M. Barnett ◽  
Derek R. Boughner ◽  
D. Wayne Taylor ◽  
Paul E. Cooper ◽  
William J. Kostuk ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Cerebral Ischemic ◽  
Ischemic Events

Preoperative single-slab 3D time-of-flight magnetic resonance angiography predicts development of new cerebral ischemic events after carotid endarterectomy

2009 ◽  
Vol 111 (1) ◽  
pp. 141-146 ◽  
Author(s):  
Taro Suzuki ◽  
Kuniaki Ogasawara ◽  
Ryonoshin Hirooka ◽  
Makoto Sasaki ◽  
Masakazu Kobayashi ◽  
...  
Keyword(s):  
At Risk ◽  
Mr Imaging ◽  
Carotid Endarterectomy ◽  
Signal Intensity ◽  
Mr Angiography ◽  
Time Of Flight ◽  
Neurological Deficits ◽  
Patients At Risk ◽  
Cerebral Ischemic ◽  
Ischemic Events

Object Preoperative impairment of cerebral hemodynamics predicts the development of new cerebral ischemic events after carotid endarterectomy (CEA), including neurological deficits and cerebral ischemic lesions on diffusion weighted MR imaging. Furthermore, the signal intensity of the middle cerebral artery (MCA) on single-slab 3D time-of-flight MR angiography (MRA) can assess hemodynamic impairment in the cerebral hemisphere. The purpose of the present study was to determine whether, on preoperative MR angiography, the signal intensity of the MCA can be used to identify patients at risk for development of cerebral ischemic events after CEA. Methods The signal intensity of the MCA ipsilateral to CEA on preoperative MR angiography was graded according to the ability to visualize the MCA in 106 patients with unilateral internal carotid artery stenosis (≥ 70%). Diffusion weighted MR imaging was performed within 3 days of and 24 hours after surgery. The presence or absence of new postoperative neurological deficits was also evaluated. Results Cerebral ischemic events after CEA were observed in 16 patients. Reduced signal intensity of the MCA on preoperative MR angiography was the only significant independent predictor of postoperative cerebral ischemic events. When the reduced MCA signal intensity on preoperative MR angiography was defined as an impairment in cerebral hemodynamics, MR angiography grading resulted in an 88% sensitivity and 63% specificity, with a 30% positive- and a 97% negative-predictive value for the development of postoperative cerebral ischemic events. Conclusions Signal intensity of the MCA on preoperative single-slab 3D time-of-flight MR angiography is useful for identifying patients at risk for cerebral ischemic events after CEA.

scholarly journals Variations in the Presence of Carotid Intraplaque Hemorrhage Across Age Categories: What Age Groups Are Most Likely to Benefit From Plaque Imaging?

2020 ◽  
Vol 11 ◽  
Author(s):  
Anthony S. Larson ◽  
John C. Benson ◽  
Waleed Brinjikji ◽  
Luis Savastano ◽  
Giuseppe Lanzino ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Age Groups ◽  
Intraplaque Hemorrhage ◽  
Plaque Imaging ◽  
Anterior Circulation ◽  
The Mean ◽  
Artery Disease ◽  
Cerebral Ischemic ◽  
Ischemic Events

Although carotid artery intraplaque hemorrhage (IPH) is a known risk-factor for cerebral ischemic events in patients of advanced age, its prevalence in younger cohorts is less certain. The purpose of this study was to assess the prevalence of carotid artery IPH across the age spectrum. A retrospective review was completed of all adult patients from our institution who underwent neck MRA with high-resolution carotid plaque imaging between 2017 and 2020. The mean ages of patients with and without IPH were calculated. The prevalence of IPH was compared between patients that were categorized into age groups. Patients with and without a cerebral ischemic event (e.g., stroke, retinal ischemia) were included. Unilateral anterior circulation ischemic events in patients without atrial fibrillation were presumed to be likely related to ipsilateral carotid artery disease. Multiple regression analysis was performed to determine independent associations with IPH. 634 patients were included (1,268 carotid arteries). Increasing age (OR: 1.04; 95% CI: 1.02–1.06; P = 0.001) was independently associated with IPH. 211 patients had unilateral anterior circulation ischemic events. The mean age of patients with carotid IPH was 71.4 years (SD = 9.9), compared to 62.8 years (SD = 15.8) of those without (P ≤ 0.0001). The prevalence of IPH increased with age in all patients (P = 0.0002). Among patients with ipsilateral anterior circulation ischemic events, each age category above 50 years had a significantly higher prevalence of IPH when compared to patients 18–50 years (P ≤ 0.05 for all comparisons). The prevalence of carotid IPH increases with age and is rare in patients under 50 years. The approximate threshold age for IPH development is likely around 50 years.

Treatable Potential Cardiac Sources of Embolism in Patients with Cerebral Ischemic Events: A Selective Transesophageal Echocardiographic Study

2004 ◽  
Vol 97 (11) ◽  
pp. 1055-1059 ◽  
Author(s):  
Abutaher M. Yahia ◽  
Aasma B. Shaukat ◽  
Jawad F. Kirmani ◽  
Andrew Xavier ◽  
Nancy G. Manalio ◽  
...  
Keyword(s):  
Echocardiographic Study ◽  
Cerebral Ischemic ◽  
Ischemic Events

Cerebral Ischemic Events in Patients with Advanced Lung or Prostate Cancer

2005 ◽  
Vol 24 (4) ◽  
pp. 230-236 ◽  
Author(s):  
Carolyn E. Behrendt ◽  
Rolando B. Ruiz
Keyword(s):  
Prostate Cancer ◽  
Cerebral Ischemic ◽  
Ischemic Events

Health related quality of life of the patients after transient ischaemic attack: is carotid endarterectomy (CEA) or carotid artery stenting (CAS) more influential?

2018 ◽  
Vol 16 (1) ◽  
pp. 61-68
Author(s):  
Mariusz Trystuła
Keyword(s):  
Quality Of Life ◽  
Carotid Endarterectomy ◽  
Health Related Quality ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
Cerebral Ischemic ◽  
One Year ◽  
Ischemic Events

Although randomized trials have proven the benefit of revascularization with the use of carotid endarterectomy (CEA) or stenting (CAS) for appropriate patients, health care purchasers increasingly look beyond clinical outcome toward measures of health-related quality of life (HRQoL) in apportioning limited resources. 36 patients after TIA participated in this study. One group (n=18) had undergone CEA, whereas the second group (n=18) had undergone CAS. Both groups were matched according to age and sex. The Short Form 36 (SF-36) was used to assess the differences in patient-perceived HRQoL in two groups of patients who had suffered minor cerebral ischemic events. No significant difference in health profile between the CEA and CAS was detected for the eight SF-36 domains. However, the CEA group rated a significantly improved change in general health after one year compared with the CAS group (p<0.001). A greater proportion of the CEA group comparing to the CAS group thought their treatment had been successful and that their health had been improved (p<0.001). Both groups shared the same level of anxiety over potential future cerebral ischemic events (p=0.3). Patients' perception of HRQoL measured by the SF-36 domains was almost identical between the CEA and CAS apart from a small but significant improvement in self-reported overall health in the CEA group after one year follow up. HRQoL outcome measures may be of value in future clinical trials of cerebral revascularization to compare the effectiveness of carotid revascularization with the particular method of operation.

A Case Report: The CSF Characteristics of HaNDL Syndrome

2020 ◽  
Vol 13 (2) ◽  
pp. 103-107
Author(s):  
Sarah E. McKay ◽  
Melanie R. F. Greenway
Keyword(s):  
Cerebrospinal Fluid ◽  
Migraine With Aura ◽  
Viral Encephalitis ◽  
Recurrent Stroke ◽  
Unique Case ◽  
Laboratory Findings ◽  
Cerebral Ischemic ◽  
Ischemic Events ◽  
Insight Into ◽  
Csf Findings

BackgroundHeadache and Neurologic Deficits with cerebrospinal fluid Lymphocytosis (HaNDL) is a rare and underdiagnosed syndrome that mimics recurrent stroke, migraine with aura, and encephalitis.ObjectiveDescribe the presentation, clinical characteristics, and cerebrospinal fluid (CSF) findings in a patient with HaNDL and provide insight into the importance of the recognition of this syndrome.MethodsThe authors describe a unique case of (HaNDL) during which the patient underwent three lumbar punctures over 26 days.ResultsThe authors demonstrate the natural course of CSF characteristics of a patient with HaNDL, with rising and falling lymphocyte counts. Additionally, the authors provide an example of the clinical presentation of HaNDL, with episodic attacks over the course of 1 month of migraine headache, hemibody paresthesias, hemibody weakness, and encephalopathy.ConclusionsHaNDL is a headache syndrome mimicking viral encephalitis, migraine with aura, and recurrent cerebral ischemic events. While HaNDL is a diagnosis of exclusion, the syndrome's association with characteristic clinical and laboratory findings are important to recognize. Furthermore, a monophasic pattern of CSF lymphocytosis in HaNDL may be observed.Implications for NursingIncreased recognition of this syndrome may help prevent unnecessary tests and treatments when patients present with recurrent episodes.

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